- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.95 / $2,844.00 / $5,146.72
| Facility | | $263.95 | $2,844.00 | $5,146.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.83 / $290.14 / $705.00
| Professional | | $239.83 | $290.14 | $705.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.28 / $3,600.11 / $26,542.00
| Facility | | $670.28 | $3,600.11 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.50 / $514.45 / $1,976.72
| Professional | | $279.50 | $514.45 | $1,976.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.27 / $1,033.32 / $3,212.69
| Professional | | $266.27 | $1,033.32 | $3,212.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.00 / $920.70 / $6,493.89
| Facility | | $837.00 | $920.70 | $6,493.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.70 / $444.28 / $850.01
| Professional | | $288.70 | $444.28 | $850.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.54 / $714.00 / $6,679.00
| Facility | | $278.54 | $714.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.36 / $399.68 / $581.66
| Professional | | $313.36 | $399.68 | $581.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.10 / $665.44 / $859.27
| Professional | | $337.10 | $665.44 | $859.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.76 / $4,959.89 / $5,580.49
| Facility | | $1,181.76 | $4,959.89 | $5,580.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.72 / $785.41 / $824.68
| Professional | | $472.72 | $785.41 | $824.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $4,249.00 / $26,542.00
| Facility | | $1,061.00 | $4,249.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.08 / $514.45 / $1,976.72
| Professional | | $300.08 | $514.45 | $1,976.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.61 / $417.27 / $900.27
| Professional | | $274.61 | $417.27 | $900.27 |